Exhibit 2 -- Cost Proposal

Bid Event # EVT0005594

COBRA Administration (2019, 2020, 2021)

Contract Effective 1/1/2019

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Exhibit 2

COST PROPOSAL

Please provide pricing options and details in each section below. List all assumptions utilized and clearly identify pricing as per eligible or per participant. If a service on this cost sheet is not offered by your company, mark the cost as “service not available”

The costs for any services for which you might bill the SEHP in relation to the product being bid, MUST be included on this Cost Proposal. If there is a service for which you charge that is not listed, include that service in the

“Miscellaneous or Additional Services” section. Optional services should be so noted. Any service not listed on your cost proposal is not billable or payable by the SEHP.

For billing purposes the Contractor will place the information on company letterhead or official company invoice and submit the invoice to SEHP for payment. Preference is for the bills to be sent in electronic media to the designated SEHP staff. Payment will be made to the contractor within three business days of the SEHP’s reconciliation of the invoice.

Financial Proposal

7.01.01- Vendors must provide detailed fixed prices for all costs associated with the administrative services and responsibilities requested in this RFP.

Description / Unit / Rate / Amount
Per Combination Fee: QE, Election and HIPAA
Per Notice Fee: Open Enrollment
Amount per COBRA Participant
Per Notice Fee: General Notice
TOTAL

7.01.02- Vendors must provide detailed fixed prices for all additional costs associated with the responsibilities and related services of this RFP. Clearly specify the nature of all expenses anticipated for each account. Please submit your cost proposal in the following format:

Describe any other type of costs or fees that may apply to this contract / Unit / Rate / Amount
TOTAL

7.01.03- Are your fees in 7.01.2 guaranteed for the life of the contract? If not, show separate columns for 2019, 2020 and 2021 for fees.

Describe any other type of costs or fees that may apply to this contract / 2019 / 2020 / 2021
TOTAL

7.01.04- Are there COBRA Initial Setup fees and Renewal fees? If so, elaborate about each expense and show in the columns below:

Setup/ Renewal Fees / Amount
TOTAL

7.01.05- List the fees below associated with COBRA Participants.

COBRA Participants / 2019 / 2020 / 2021
Current COBRA Participant Takeover Fees
Qualifying Event Notice
Open Enrollment Packet Fee
Billing for Administration
TOTAL

ACKNOWLEDGE AND ACCEPT

The Rate Schedule section of the Request for Proposal has been reviewed by me and shall become part of the final contract. I hereby acknowledge and accept all of the rates proposed in this section of Request for Proposal, subject to the modifications, conditions and limitations I have listed below.

______

Authorized Signature of Vendor

______

Printed Name of Signatory

______

Title

______

Date

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